Many symptomatic Australians not staying home or getting testing

Anastasia Tsirtsakis

29/09/2020 2:30:38 PM

This is despite compliance with other COVID-safe behaviours remaining high, a Monash University survey has found.

Man in public sneezing
More than a third of respondents with cold- or flu-like symptoms spent time in public.

The latest results from wave eight of the Survey of COVID-19 Responses to Understand Behaviour(SCRUB) project, released on 29 September, show more than a third (36%) of Australians with cold- or flu-like symptoms spent time in public and almost one in five (18%) attended work in person.
While symptomatic, just 33% wore a face mask, 24% avoided close contact with those they live with, 15% visited someone else’s home and 11% had visitors to their home.
The survey also raised concerns over testing rates.
Despite showing an upward trend from the previous round of SCRUB, just 27% reported getting tested for COVID-19.
One fifth said they did not get tested because they did not think they had the virus, and 10% had another medical condition that they believed explained their symptoms.
Of those who did get tested, 13% did not stay home while waiting for their results, of whom 15% said they were not aware they needed to.
However, overall compliance with COVID-safe behaviours remains high, with 81% of Australians reporting that they always or often follow rules and regulations compared to 2% who report rarely or never following the rules.
The data was collected from a representative sample of 1003 Australians between 31 August and 4 September. 
Lead researcher Dr Peter Slattery from BehaviourWorks Australia, which is leading the Australian chapter of SCRUB in partnership with the Victorian Government, told newsGP this round of results is conflicting.
‘I find it very interesting that there’s such high compliance with all of the protective behaviours in general and that, that’s increasing,’ he said.
‘But at the same time, such a small percentage of people with symptoms are getting tested. In one sense it’s quite a jump from 15% to 27% – that’s almost doubling. But from another perspective, three out of four basically decided not to get tested.’
Dr Slattery says people’s reluctance to get tested may be influenced by the relatively low community transmission across the country.
‘People will have a tendency to think it’s just such a low probability, especially in places where there aren’t live cases in the community or very, very few. People might be thinking it’s just so unlikely that this is COVID-19 and it just seems like a lot of hassle,’ he said.
‘It’s a really unwise gamble to take. You save a little bit of time, but if you get it wrong, then there could be a huge downside for you and for everybody else, because you’ll maybe be restarting the virus in your community.’
The survey also provides insight into how Australia’s mental health is tracking, and what is concerning the population overall.
An economic recession (62%) emerged as the biggest concern for participants, followed by society becoming more selfish (55%), small companies failing (54%), people they love dying (44%) and the health system being overloaded (44%).
Despite their worries, Australians were generally found to have good mental health, with 77% reporting that they are in good to excellent mental health. But 30% did say their mental health had declined overall, reporting that they have much worse or somewhat worse mental health than before the pandemic.
Dr Slattery says both the survey findings and the declining incidence of the virus in Australia indicates that COVID messaging has been largely successful.
But with testing a key part of the coronavirus road to recovery, the findings do raise concerns.

Nearly one in three respondents said their mental health has declined overall during the pandemic.
Dr Slattery says there is a need to delve deeper into the data to better understand the attitudes and behaviours of different cohorts.
‘There should be more of an emphasis on the importance of testing, even if you only have trivial symptoms, and particularly directed messaging; identifying who are the problem groups,’ he said.
‘Who do they listen to? Who do they pay attention to? And making sure that the messaging is in their line of sight.
‘It may be the case that a lot of messaging is reaching people who are already compliant, and the problem groups are not being reached by that messaging because it’s just not been put in channels that they pay attention to.’
Dr Slattery says people’s behaviour can be broken down into three steps: ‘awareness, ability and motivation’.
‘We really need to maximise awareness. Keep people aware that just because there are no active cases in your community it doesn’t mean that there isn’t a risk that there will be soon – this isn’t an unprecedented thing, the virus has gone and returned to two different communities in the past – and keep people aware that there is a threat,’ he said.
‘Also, make it both easy to get the test and make people believe that it’s easy. I have heard, for example, some stories about not having good signage for different places and there are sometimes queues for getting a test.
‘So reducing all of those barriers, and then showing examples of people getting tested. You can truthfully say that more and more people are getting tested, you can truthfully show examples of figureheads and role models getting tested.
‘So I think doing all of that, particularly when we understand who we want to target, doing it very carefully directed at those groups, is the right thing to do.’
Within that strategy, Dr Slattery says GPs also have a key role to play.
‘GPs are generally well-respected by their patients and they can do their bit to make people aware that they should be getting tested,’ he said.
‘To do their best to make the testing seem accessible and a normal choice to make, and recommending anybody with symptoms to go for a test.
‘We cannot have symptomatic people acting as though they don’t have the virus when they simply can’t be sure. That’s one of the ways the virus spreads and it will continue to be an issue unless more people get tested and isolate until they receive a negative result.’
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Dr Aletia Vivienne Johnson   30/09/2020 9:43:45 AM

I’m a GP in Ipswich, QLD, and I have to say I’m very proud of my community. We’ve been the epicentre of the second wave in QLD, and we’ve done really well here. Anyone who has even slight symptoms gets sent for testing, and people are happy to go, for the most part. I’ve also been testing for other viruses at the same time. It makes people happier to get tested, because even though you ‘know’ you don’t have COVID, it’s nice to know what you DO have (mostly rhinovirus and ‘unknown’), so it gives you something too, not just the rest of the community. This helps you plan your life and your recovery. For example, rhinovirus is not the innocent little germ that people think it is. Some people get sniffles for a few days, others get bedbound for 3 weeks. It’s also highly contagious, much like COVID (One of my patients referred to it as ‘kindy plague’!). Once people know this, they can take ownership of their illness and hence, they become better at staying home until they’re better.

Dr Aletia Vivienne Johnson   30/09/2020 9:57:42 AM

Another part of our success is communication. Our public health unit, PHN, HHS, QLD Health and State Government have all been wonderful. I get emails from QLD Health every few days with statistics, contact tracing locations, testing locations and PPE updates. Our Premier has been very strict with border control and we locallyadopted universal masking early, at least at the doctors, ideally at the shops too. The Government website works well, even on your phone, so patients (and doctors) can see the latest hotspots in almost real time, and to get tested, all you have to do is put in your postcode and it will tell you where all the local testing locations are (permanent and pop up), whether you need a referral, and what time they’re open. Carpark clinics are now widespread, to keep germy people out of the consult rooms, and allowing doctors to don PPE first, and carpark testing is common too, usually with a nose and throat swab, rather than a ‘brain scraper’, which makes everyone happy.